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GFLIP
01-28-2007, 01:46 PM
A 54 yo female comes into your office with complaints of malaise, fatigue, and chest pain with exertion. After taking a detailed history, you find out that she has Type I Diabetes Mellitus. You decide to get some labs. Laboratory studies show HbA1C at 12%, plasma glucose at 223 mg/dl, increased BUN, and macroalbuminuria. On fundoscopic examination, you notice retinopathy. What else is likely to be in this patient?

a. Hypothyroidism
b. Hypoparathyroidism
c. Decreased plasma creatinine
d. Normocytic anemia
e. Increased plasma calcitriol

unknownunknown
01-30-2007, 08:27 AM
I don't know. I would guess AAAAAAAAAAAA.

doc22577
01-30-2007, 12:31 PM
i think it is normocytic anaemia due to chronic renal failure, low erythropoetin

hallo
06-07-2007, 03:45 PM
i would guess it's d. Normocytic anemia.

if it were hypothyroidism wouldn't her glucose be higher? since they tend to gain weight? -silly logic, oh well.

GFLIP
06-22-2007, 08:33 PM
Answer is D.

Diabetic nephropathy is the leading cause of end stage renal disease and the HbA1C indicates poorly controlled diabetes. As the patients poorly controlled diabetes starts to damage the kidneys, proteins start to leak into the urine --> macroalbuminemia indicates end stage renal disease. Also in chronic renal disease, you will see increased BUN and creatinine. Normocytic anemia is caused by lack of erythropoietin production, which is due to the kidney damage. Retinopathy is just another clue indicating microvascular damage, just like nephropathy. Malaise, fatigue, and chest pain are symptoms that also support anemia.







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